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General NPI Number Information
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NPI Number | 1770768111
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Entity Type | Individual
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Provider Name | MICHELLE H CLEARY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 219 36TH ST NO 25/GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11232-2547
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Country | US
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Telephone | 646-783-2992
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Fax |
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Provider Business Mailing Address
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Address Line | 219 36TH ST. NO 25/GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11232-2547
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Country | US
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Telephone | 646-783-2992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 067409
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 080883
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License Number State | NY
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